title: Electrographic seizures in pediatric ICU patients: cohort study of risk factors and mortality.
abstract: OBJECTIVE
  We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality.
  
  
  METHODS
  Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality.
  
  
  RESULTS
  Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category.
  
  
  CONCLUSIONS
  Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality.
authors.affiliation: Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. abend@email.chop.edu
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Abend
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Arndt
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Carpenter
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Chapman
authors.forename: Karen M
authors.initials: KM
authors.lastname: Cornett
authors.forename: William B
authors.initials: WB
authors.lastname: Gallentine
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Giza
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Goldstein
authors.forename: Cecil D
authors.initials: CD
authors.lastname: Hahn
authors.forename: Jason T
authors.initials: JT
authors.lastname: Lerner
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Matsumoto
authors.forename: Kristin
authors.initials: K
authors.lastname: McBain
authors.forename: Kendall B
authors.initials: KB
authors.lastname: Nash
authors.forename: Eric
authors.initials: E
authors.lastname: Payne
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Sánchez
authors.forename: Iván Sánchez
authors.initials: IS
authors.lastname: Fernández
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.forename: Korwyn
authors.initials: K
authors.lastname: Williams
authors.forename: Amy
authors.initials: A
authors.lastname: Yang
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Dlugos
mesh_terms: D000293:Adolescent; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004569:Electroencephalography; D004827:Epilepsy / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D016015:Logistic Models; D008297:Male; D009656:North America / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult